Unlocking Blocked Care: 7 Simple Steps to Rekindle Your FASD Caregiving

In the unique and often misunderstood world of parenting children with Fetal Alcohol Spectrum Disorder (FASD), caregivers frequently face a challenging phenomenon known as blocked care. This issue arises not from a lack of love or effort, but from an ongoing cycle of adversarial parent-child interactions that cause caregivers to lose touch with their feelings of love, hope and motivation. Rather than feeling confident and fulfilled in their parenting roles, caregivers begin to find themselves dreading everyday parenting tasks, feeling unmotivated, avoidant and constantly cautious or hypervigilant to avoid triggering an all-but-certain negative reaction from their child. Such responses from the child can range from constant angry defiance and verbal outbursts to tantrums, meltdowns, and physical aggression, further complicating the caregiving dynamic.

Over time, these manifestations — or, more precisely — these symptoms of FASD and past traumas can lead caregivers to feel emotionally exhausted, painfully rejected and even mentally abused. They feel trapped in a cycle that diminishes their ability to connect and provide nurturing, attuned care — effectively dampening their caregiving instinct. They may feel as though they are holding a tiger by the tail, fearful that setting firmer boundaries will lead to even more intense confrontations or emotional fallout. This ongoing stress can alter caregivers’ belief system, diminish their sense of personal efficacy, and isolate them from family, friends and professionals who do not comprehend the untenable double-binds and complexities of their situation.

‘Blocked Care’ is a specific, survival-based caregiver response to prolonged periods of toxic stress and chronic conflict within a caregiver-child relationship that dampens or ‘blocks’ the caregiving instinct.

Furthermore, blocked care is deeply interconnected with the child’s experience of blocked trust, stemming from their neuro-atypical condition of FASD and compounded by the child’s developmental trauma and past abuses. Navigating a world that feels incessantly and overwhelmingly hostile can exacerbate the child’s challenges, potentially leading to destructive outcomes such as chronic and toxic stress, poor health issues (like headaches, migraines, high blood pressure, etc.), social isolation, and even child protections and substance use.

Understanding the Roots of Blocked Care

‘Blocked Care’ is a survival-based response that emerges after prolonged periods of toxic stress and relentless conflict within a caregiver-child relationship. This stress dampens or ‘blocks’ a caregiver’s natural instincts or motivation to nurture and support their child, transforming caregiving from a labor of love into a taxing ordeal.

Children with FASD often struggle with symptoms like impaired impulse control, difficulties in sensory processing, and challenges in auditory reception, and predominantly concrete thinking. When these children react with aggression, resistance, or make hurtful remarks, it reflects their overwhelmed state. These behaviors, challenging as they are, are manifestations of the children’s struggles; they are not deliberate acts of defiance, manipulation, or sociopathy. Instead, they represent the child’s attempt to navigate the overwhelming internal chaos of their own emotions and the neurological turmoil that can be present in FASD.

Each outburst or challenging behavior is a cry for help — a signal of distress from a neuro-atypical child grappling with internal and external pressures that exceed their coping abilities. They are overwhelmed, much like a dam that has surpassed its capacity, leading to unintended spillover and damage. This analogy highlights the intense and often unmanageable burden these children face, resulting in reactions that can disrupt and hurt, despite not being purposefully destructive.

The Impact of Developmental Trauma

Even a children (with or without FASD) who join good, stable, loving homes as infants can experience developmental trauma. This issue further complicates their ability to trust and connect with caregivers.

While FASD already impacts neurological functions, additional layers of unseen developmental traumas, past abuses, or even benign neglect before being placed in a nurturing environment can exacerbate these challenges. Such a complex background can render the child impossible to soothe or comfort, leading to repeated experiences of misunderstanding and misattunement.

This occurs when caregivers, despite their best intentions, cannot adequately understand or meet the child’s needs due to the child’s overwhelming state. This kind of care, even if unintentional and stemming from nearly impossible conditions, effectively ‘teaches’ a child that comfort is elusive and that people, even those who mean well, can unintentionally exacerbate their distress or harm them.

Over time, this repeated cycle of misattunement and misunderstanding can build a fortified wall of self-protection around the child. They may begin to misinterpret and perceive even well-intentioned, attuned interactions as threats, leading them to preemptively and reflexively adopt survival strategies such as flight, fight, freeze, or faint behaviors.

These behaviors or symptoms, though protective in nature, are often perceived by others, including caregivers, as negative or aggressive. As a result, both the child and the caregiver may find themselves trapped in a cycle where they feel compelled to defend themselves, sometimes even preemptively, to ensure their emotional and physical safety.

Recognizing the Signs of Blocked Care

If you’re reading this, you might be wondering whether you’re at risk for blocked care, beginning to recognize it in your own life, or perhaps already deeply entangled in its grasp. It’s crucial to discern whether you’re experiencing the early stages of frustration and exhaustion or if you’re further along this challenging path.

Firstly, identifying blocked care should begin with the caregiver, not the child. This is a relational dynamic, and as caregivers, we have more capacity for change, unlike our neuro-atypical children, who lack the same ability to adapt their behaviors spontaneously. Initially, our focus should be on understanding and managing our reactions to the child’s behaviors. To be sure, we will use the child’s reactions to us and their behavioral symptoms to guide our interventions, but that comes after we have understood and taken care of ourselves first.

Blocked care often starts with a caregiver feeling frustrated or exhausted, feeling that no matter what you do — be it increased affection, stricter discipline, different medications, or various therapies — nothing seems to work. This might also have led you to letting the little things go, which can feel counterintuitive or be met with criticism, making you feel like a lenient or even negligent parent.

As blocked care progresses, you may double-down on your consequences and punishments, enforcing stricter rule, like locking up cabinets in the kitchen or hiding your valuables in secret. Feelings of resentment may start to overshadow guilt, patience may dwindle, and feeling overwhelmed becomes the new status quo.

More severe signs of blocked caregiving include detachment, a pervasive sense of hopelessness, and increased resentment and anger, often in anticipation of the child’s outbursts. Personally, I reached a point where I told myself ‘I don’t care’ — even though I really did — and found myself preferring to stay at work or wander a mall rather than return home. These are signs of moving into a significant phase of blocked care, and I found myself to be at a medium (and occasionally high) level of blocked care.

The turning point for me was recognizing that the chronic stress was affecting my health — manifested through weight gain, high blood pressure, and constant headaches. This realization led me to embrace what I call radical self-care, and it was the beginning of a new approach to managing my wellbeing and altering my caregiving approach.

Pathways to Unblocking Blocked Care

Here are seven strategies that I used to heal from my own blocked care and growing indifference toward more love and motivation in my own parenting journey. Things did not change overnight, but they did change with sustained and supported effort on all seven of these strategies. It is worth noting that strategies one through four involve only the caregiver, while strategies five through seven are relational and involve caregiver and child. This highlights the critical importance of caregivers taking the lead in improving the caregiver-child relationship.

  1. Prioritize Self-Care for Sustainability and Health: Remember, “You cannot pour from an empty cup.” If you don’t believe in this step or otherwise skip it, then you are likely to stay at least partially immersed in blocked care. You may not believe in it, you may feel guilty for doing it, or you may ‘not have time’ for it, but you must engage in self-care practices that rejuvenate you physically, mentally, socially-emotionally, and spiritually. Simple practices like mindful breathing, regular walks, and journaling can be powerful, as can larger acts of self-care like taking a personal day or planning a weekend retreat when possible. “PQ Reps” from the field of Positive Intelligence are simple and highly effective practices that can have both immediate and longer term benefits, and I will discuss these in detail in other articles. Bottom line: all of these self-care practices build your resilience, directly improve your caregiving effectiveness, and begin unblocking you from blocked care.
  2. Don’t Take Anything Personally: From the book “The Four Agreements,” the author Don Miguel Ruiz says that we take things personally when we unconsciously agree with whatever is said about us. However, when anyone says something about us, they are actually dealing with their own anger and fear. By keeping this agreement, you do not let their anger trigger you, and then you can avoid many upsets in caregiving. This freedom from your child’s anger and fear can then foster self-compassion and a nurturing approach towards your caregiving journey, which supports unblocking your care and self-care. This agreement is hard to keep — believe me! — but stay aware that your child’s fear and anger stems from their blocked trust and is not personally about you. Practice saying ‘Do not take this personally’ whenever your child is showing negative symptoms so that you can start unlocking your blocked care.
  3. Seek Support from Those Who ‘Get It’: Connect with local or online support groups where members share caregiving experiences of children with FASD or similar challenges. I cannot overstate this enough and have personally felt a visceral sense of relief when fellow parents in my own support group simply listen in a nonjudgmental, validating way to the unbelievable experiences we caregivers have. As an FASD Coach, I also see the power of being heard and of witnessing a strong, supportive and wise community of caregivers in the online FASD Success groups that I have had the privilege to be a part of since 2021. Even ‘just listening’ to Jeff Noble’s FASD Success Show Podcast can expose you to this type of support and inspired hope.
  4. Do Your Grief and Loss Work: This is painful work, but it is necessary. You can do this on your own with journaling, meditation, prayer or even books on grief, but it works best inside a supportive group — either a grief group or an FASD caregiver support group — and in relation to others who are or have been there too. This is another important reason to find your FASD community. As a part of grief work, acknowledge and process your feelings of grief about not only the hard experiences that have led to your blocked care, but also the anticipatory grief of the lost future hopes and expectations you almost certainly have about your child, about how your family is and will be, and about what kind of caregiver your child needs versus the kind of caregiver you thought you wanted to be. This might involve facing painful truths and actively working through them, a process that often requires revisiting and reassessing as life progresses, and is best done in a supportive community of fellow caregivers.
  5. Embrace a Strengths-Based Perspective: This concerns the strengths of both your child and of you! Shift your focus from your child’s limitations to their capabilities and possibilities, and from your perceived failures to your strengths and progress (not perfection). Apply structured parenting strategies like ‘Praise for Change’ to reinforce and celebrate boundaries and achievements, all while creating better attunement with your child or teen with FASD. This approach not only fosters a positive environment but also empowers your child by emphasizing their potential. My own kid did not trust my initial efforts as I was developing this strengths-based approach that strategically uses praise over time, but I was amazed how well it worked to improve our relationship and his compliance. A strengths-based approach is hard to pull off alone and may require some coaching; this was necessary in my own experience and came from a fellow foster parent and Ojibwe elder, Great Grandmother Mary, who effortlessly reframed problems into strengths and opportunities.
  6. Work on Essential Symptoms Only: There are so many moving parts that an FASD Caregiver can see as potential and actual problems. However, when we try to fix everything, we end up fixing nothing because then things only get tinkered with, not fixed. The difficult but necessary task when we are in a state of chaos or blocked care (or both) is to focus on managing only the most critical child symptoms. A great book that I used to help me decide what these are is ‘The Explosive Child’ by Ross Greene. I had read that book as a psychologist, but it was pure gold to read it as a caregiver. In a nutshell, you divide your child’s symptoms into three categories, or ‘parenting baskets.’
    Basket A contains only the non-negotiable safety or other behaviors that are so important that you are willing to endure a tantrum or meltdown in order to enforce. As I became a more experienced foster parent, Basket A shrank quite a bit. I would sometimes feel benignly negligent about the behaviors I moved out of Basket A (and mostly to Basket C, quite honestly), but trying to do everything is part of what landed me in the zone of blocked care to begin with.
    Basket B holds only the symptoms and behaviors that you as a caregiver are 100% committed to working on. Again, the more experienced I became as a foster parent, the less this basket held, too. In fact, when we were really doing the hard work, there would only be two or possibly three things to work on in this basket. Remember, the more you try to do under these conditions, the less you get done and the more blocked care and burnout you feel. Only keep one to three symptoms to work on in Basket B when you are experiencing blocked care.
    Basket C gets everything else. Yes, theoretically everything. You have to set aside almost every other parenting goal or expectation — at least in theory — to get the items in Basket B working better. Once a symptom is handled and manageable, you can move it to your list of successes and add another one to Basket B for intense work, but you have to be willing to work on only your essential Basket B goals and put everything else in Basket C for later. This harm reduction strategy helps maintain sanity and progress in manageable increments by eliminating worry or focus on any unrealistic or nonessential expectations.
  7. Cultivate Connection Before Correction: This strategy can assist you in deciding on or reevaluating the essential symptoms for your parenting baskets in the previous strategy. A great rule of thumb for using this strategy is ‘relationship first.’ Do things that establish a strong, trusting, harmonious relationship with your child before attempting to correct too many behaviors. This foundational connection is crucial, as a child in a blocked care situation may struggle to accept even constructive criticism without a solid relationship and a properly attuned praise delivery system such as that in Praise for Change. This connection becomes the foundation upon which you can branch out and build other more effective strategies for guidance and support over time. My son regularly asks me for advice now because of my investment in these strategies over time; I never would have believed it was possible in the midst of my blocked care, but it was, and it can be for others, too.

The Journey Forward

Healing the caregiver-child relationship is a delicate process that requires patience, understanding, and unwavering commitment. It’s about methodically breaking down the barriers of blocked trust and care, one interaction at a time, through moments of connection, deep understanding, and unwavering acceptance. This path is not swift; it demands time and persistence, but with the appropriate support and strategies, healing is within reach, and a more profound, resilient bond with your child can be developed. My own experiences attest to the reality of this transformation.

Navigating the complexities of blocked care underscores the depth and intricacy of the caregiving journey, especially for children with FASD. By adopting radical self-care and the strategies outlined in this discussion, caregivers can begin to mend the fractures in their relationships. This opens the door to a more connected and empathetic relationship with their child, where both parties can feel acknowledged, supported, and cherished. While the family dynamic might not mirror the idealized version you once envisioned, it can evolve into something genuinely real, progressive, and fulfilling.

[originally published on Medium.com]

Take the Next Step in Your Caregiving Journey

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